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Child Welfare Agencies

When it comes to supporting the healthy sexual development of youth in foster care, county child welfare agencies have a legal duty to:

  1. Use the reasonable and prudent parent standard to create normalcy and support the healthy sexual development of youth in foster care based on their individual need
  2. Ensure youth in foster care receive health services to meet their medical and mental health needs 
  3. Ensure the rights in the Foster Care Bill of Rights are honored 
  4. Ensure that caseworkers receive SB 89 compliant sexual health training 
  5. Ensure that caseworkers are appropriately documenting their conversations about rights and access to sexual health education in the case plan and CWS/CMS as required by SB 89. 
  • All County Letter (ACL 19-27) provides guidance on supporting gender affirming care.
  • All County Letter (ACL 16-32) shows documenting pregnancy and parenting in CWS/CMS.
  • All County Letter (ACL 16-82) states Reproductive and sexual health care and related rights for youth and non-minor dependents (NMD) in foster care.
  • All County Letter (ACL 16-88) states California’s plan for the prevention of unintended pregnancy for youth and non-minor dependents (NMD).
  • All County Letter (ACL 18-61) states how to document Reproductive and Sexual Health care needs and rights of foster youth in CWS/CMS.
  • All County Information Notice (ACIN I-06-20) has guidance on how to document sensitive information in CWS/CMS and a case plan.
  • Foster Youth Bill of Rights
  • Consent and confidentiality rights of youth in foster care.
  • Facts about the California Foster Youth Sexual Health Education Act (Senate Bill 89).
  • Fast facts about the California Healthy Youth Act.

Child Welfare Caseworkers

Caseworkers have specific duties related to supporting the healthy sexual development of youth and nonminor dependents in foster care. These include: 
Supporting Access to Healthy Sexual Development Information and Education by
  • Providing the youth with a copy of their foster youth rights upon entry into faster care and at least once every six months. 
  • Informing each youth age 10 and older of (1) their right to age appropriate, medically accurate information about reproductive and sexual health care, (2) their right to consent to and right to confidentiality in such services, and (3) how to access reproductive and sexual health services, at least once a year. 
  • Verifying and Connecting: verifying the youth has received sexual health education at least once in middle school and at least once in high school – and if they have not, connecting them to a state mandate compliant education program in the community. 
  • Documenting in the case plan that they have notified youth of their rights to access information and verified sexual health education annually.  
Facilitating Access to Sexual and Reproductive Health Care by 
  • Ensuring youth are up to date on annual medical appointments  
  • Facilitating access to care 
  • Assisting in addressing identified barriers to care in a timely manner, such as ensuring youth have transportation support, privacy in exam rooms, confidentiality, access to provider of choice, and access to gender affirming and trauma informed, culturally responsive care.  
Honoring privacy law by 
  • Documenting in the case plan a way that protects privacy 
  • Explaining the limits of privacy and respecting youth requests to limit disclosures of sensitive information about gender identity or expression, sexual orientation or sexual and reproductive health status. 
The California Foster Youth Sexual Health Education Act, Senate Bill 89, passed in 2017, mandated that all child welfare caseworkers receive training on sexual and reproductive wellness for youth in foster care that includes information on the rights of youth to education and care, the duties of the child welfare agency and caseworker to support access, a review of basic services available, and guidance and support on how to engage and talk with youth about healthy sexual development in a way that is medically accurate, age appropriate, strengths based and trauma informed. The trainings on this page support compliance with this mandate and/or address other sexual and reproductive health topics that caseworkers frequently ask about.
Training Curriculum
  • View an SB 89 compliant curriculum for resource family pre-approval training to empower caregivers to support foster youth with their sexual and reproductive wellness.
Other Training Resources
These resources can help you understand, support, and protect foster youths’ reproductive and sexual health rights. Organized by types of audiences who may want to access this information, these resources can help you learn about foster youth rights, programs, and services available as well as help you find solutions to challenges that foster youth face in accessing reproductive and sexual health care.
Caseworker Resources
  • Sample SB 89 Reference Guide for LA County DCFS
  • Frequently Asked Questions for documenting, protecting, and sharing reproductive and sexual health information of youth in foster care.
  • Guide to team conferencing for expectant and parenting youth.
  • Guide for case managers about assisting foster youth with healthy sexual development and pregnancy prevention.
  • Guide for child welfare providers about caring for LGBTQ children & youth.
  • Chart about minor sexual intercourse reporting.
  • Use this website for clinic referral resources.
  • This document helps determine if a clinic is right for youth.
  • Find more resources for youth on our website.
  • Clinical guidelines on responding to adolescent relationship abuse
  • Youth and caregiver speak PowerPoint on Creating Stronger Caregiver-Youth Relationships by embracing awkward conversationsThis webinar is part 2 of the 2020 LA RHEP Summer Learning Series.
  • Advice from youth for youth PowerPoint on Self-Love, Sexual Intimacy, and Healthy Relationships amid COVID-19
  • Parenting Youth Speak video on how they are experiencing COVID-19 and ways to support them. This webinar is part 3 of the 2020 LA RHEP Summer Learning Series.
  • Youth perspective video on Health and Health Access in Times of COVID-19.
  • Full report on former foster youth experiences with barriers and healing during COVID-19 
  • Report Summary on former foster youth experiences with barriers and healing during COVID-19 

Child Welfare Agencies

When it comes to supporting the healthy sexual development of youth in foster care, county child welfare agencies have a legal duty to:
  1. Use the reasonable and prudent parent standard to create normalcy and support the healthy sexual development of youth in foster care based on their individual need 
  2. Ensure youth in foster care receive health services to meet their medical and mental health needs 
  3. Ensure the rights in the Foster Care Bill of Rights are honored 
  4. Ensure that caseworkers receive SB 89 compliant sexual health training 
  5. Ensure that caseworkers are appropriately documenting their conversations about rights and access to sexual health education in the case plan and CWS/CMS as required by SB 89. 
Resources and support

Child Welfare Caseworkers

Caseworkers have specific duties related to supporting the healthy sexual development of youth and nonminor dependents in foster care. These include: 
Supporting Access to Healthy Sexual Development Information and Education by
  • Providing the youth with a copy of their foster youth rights upon entry into faster care and at least once every six months. 
  • Informing each youth age 10 and older of (1) their right to age appropriate, medically accurate information about reproductive and sexual health care, (2) their right to consent to and right to confidentiality in such services, and (3) how to access reproductive and sexual health services, at least once a year. 
  • Verifying and Connecting: verifying the youth has received sexual health education at least once in middle school and at least once in high school – and if they have not, connecting them to a state mandate compliant education program in the community. 
  • Documenting in the case plan that they have notified youth of their rights to access information and verified sexual health education annually.  
  • Where does it say this in the law? Click here 
  • How to document this in CWS/CMS? Click here
  • Need tools to support having these conversations?
  • For RHEP tool and sample scripts for age- and developmentally -appropriate conversations with youth, click for English, Spanish
Facilitating Access to Sexual and Reproductive Health Care by 
  • Ensuring youth are up to date on annual medical appointments  
  • Facilitating access to care 
  • Assisting in addressing identified barriers to care in a timely manner, such as ensuring youth have transportation support, privacy in exam rooms, confidentiality, access to provider of choice, and access to gender affirming and trauma informed, culturally responsive care.  
  • Where does it say this in the law? Click here 
  • For clinic referral resources, click here. 
  • For guidance on supporting gender affirming care, click here. 
  • For fast facts about the California Healthy Youth Act, click here.
Honoring privacy law by 
  • Documenting in the case plan a way that protects privacy 
  • Explaining the limits of privacy and respecting youth requests to limit disclosures of sensitive information about gender identity or expression, sexual orientation or sexual and reproductive health status. 
  • What is the applicable law? click here
  • For guidance on how to document sensitive information in CWS/CMS and a case plan, click here. 
  • For tips on talking to youth about confidentiality, click here. 
The California Foster Youth Sexual Health Education Act, Senate Bill 89, passed in 2017, mandated that all child welfare caseworkers receive training on sexual and reproductive wellness for youth in foster care that includes information on the rights of youth to education and care, the duties of the child welfare agency and caseworker to support access, a review of basic services available, and guidance and support on how to engage and talk with youth about healthy sexual development in a way that is medically accurate, age appropriate, strengths based and trauma informed. The trainings on this page support compliance with this mandate and/or address other sexual and reproductive health topics that caseworkers frequently ask about.
Training Curriculum
  • View an SB 89 compliant curriculum for resource family pre-approval training to empower caregivers to support foster youth with their sexual and reproductive wellness.
These resources can help you understand, support, and protect foster youths’ reproductive and sexual health rights. Organized by types of audiences who may want to access this information, these resources can help you learn about foster youth rights, programs, and services available as well as help you find solutions to challenges that foster youth face in accessing reproductive and sexual health care.
Caseworker Resources
  • Here is a sample SB 89 Reference Guide for LA County DCFS
  • For a list of frequently asked questions, click here.
  • For a guide to team conferencing for Expectant and Parenting Youth, click here.
  • For talking points for case management worker, click here.
  • For a guide for case managers, click here.
  • To learn about developmentally appropriate approaches, click here for English or Spanish.
  • To learn more about caring for LGBTQ children & youth, click here.
  • To learn about minor sexual intercourse reporting, click here.
  • To learn whether youth are hanging out or hooking up, click here.
  • To view All County Letter (ACL 19-27) that states gender affirming care for minors and non-minor dependents, click here.
  • To view All County Letter (ACL 16-32) that shows documenting pregnancy and parenting in CWS/CMS, click here.
  • Reproductive and sexual health care and related rights for youth and non-minor dependents (NMD) in foster care, (CDSS All-County Letter 16-82)
  • California’s plan for the prevention of unintended pregnancy for youth and non-minor dependents (NMD) (CDSS All-County Letter 16-88)
  • Self-Taught Podcast: Former Foster Youth On Sex, Health, And Life
  • Fostering Parenthood Podcast Reimagining “The Talk” With Caregivers And Foster Youth.
  • RHEPcon23 Session: Supporting Youth Survivors of Commercial Sexual Exploitation Through Reproductive Experiences
  • (Webinar PDF) Youth and Caregiver Speak: Creating Stronger Caregiver-Youth Relationships by embracing awkward conversations. This webinar is part 2 of the 2020 LA RHEP Summer Learning Series.
  • (Webinar Video) Parenting Youth Speak: How we are experiencing COVID-19 and ways to support us. This webinar is part 3 of the 2020 LA RHEP Summer Learning Series.
  • (Webinar Video) Youth Perspective on Health and Health Access in Times of COVID-19
  • (Full Report PDF) Telling Our Own Stories: Former Foster Youth Experiences with Barriers and Healing During COVID-19 
  • (Report Summary PDF) Telling Our Own Stories: Former Foster Youth Experiences with Barriers and Healing During COVID-19 
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